Biodesign fellows to focus on innovation in orthopedics

Each year, a new group of Biodesign Innovation Fellows comes to Stanford to learn a hands-on process for health technology innovation. The 12 engineers, doctors, and business people (four are shown brainstorming at right) arrive knowing they will spend the next year identifying important unmet medical needs, inventing a technology to address the most compelling of those needs, and then developing a business plan to bring their new solution to patients. What they don’t know is the focus of their innovations.

"We keep the clinical focus a secret until the fellows actually arrive," said Emily Johnson, fellowships manager for Stanford’s Byers Center for Biodesign. "Changing the focus each year opens new opportunities for innovation and makes it easier on the Stanford clinicians who volunteer countless hours to lecture, host our fellows in the hospital and clinics and serve as expert advisors." It also prevents the new fellows from studying the specialty area until they arrive at Stanford, so they enter into their training experience with an open mind and a fresh perspective.

This year, the fellows will work in orthopedics, a field that addresses people’s bones and joints from "the neck to the toes," described Stephanie Pun, MD, a Stanford orthopedic surgeon. In a kickoff discussion with the fellows, Pun explained that orthopedics has numerous opportunities for innovation, from traditional targets such as implants and devices to emerging fields in biologics, wearables, and imaging.

Pun is one of more than 20 Stanford orthopedic clinicians who have volunteered their time to work with this year's fellows. Their first job will be to help the fellows identify the most compelling unmet needs. To do this, the fellows will spend a month shadowing the clinicians in a range of settings including the OR, clinic, and occupational/physical therapy centers.

"It’s important for the fellows to see for themselves the challenges that patients and providers face so they can truly understand the problems that most need to be solved," Johnson said. "It’s one thing to read about these issues in the literature. But when you observe them in person you get a much clearer understanding of the pain, suffering, frustration, and costs that they create."

In her introductory talk, Pun described some of the most pressing challenges in her field. "Orthopedic trauma needs less invasive repair techniques and tools to promote early stabilization, as well as better ways to prevent or treat bone infection," she said.

"There are currently no good options besides a joint replacement for severe arthritis. Ideally, we would identify 'at risk' joints and intervene either before or once the cartilage starts to wear down, but it is also remains difficult to catch the patient at the ideal time for joint preservation procedures."

Replacement joint longevity is another concern. "Although modern joint replacements are very durable, it’s hard to predict exactly how long a replacement joint is going to last," Pun said.

Within orthopedics, the fellows could choose to address problems that affect children or older adults, and address needs ranging from those related to everyday mobility to the problems of world-class athletes seeking to sustain or regain their optimal performance.

"There are all kinds of areas that can be improved, which is why we’re so excited to be partnering with Stanford Biodesign this year," Pun said.